骨髓型急性放射病的人体模型研究

1980年起结合自体,同种骨髓移植、胎肝细胞移植以⁶⁰Co治疗机进行全身舜射(TBII 5.O～9.9Gy)、全淋巴区照射(TLI,一次6～8Gy)和一次半身8Gy辐射技术和剂量学研究,分别应用于8倒急、慢性白血病I恶性淋巴瘸等30例,晚期肿瘤112例,设计和建立了极重度、重度、中度、轻度骨髓型急佳放射病人体模型。物理剂量误差控制在士3%以内,⁶⁰Co治疗机空间输出在受照人体范围内空间分布降至士1%以内,生物剂量主要用外周血淋巴细胞染色体畸变。监测了早期诊断分类指标,观察临床反应,并与事故性病例和实验狗资料进行对比,探讨了本人体模型的特性和局限性及其所起的作用和效益：培训了干部； 取得了良好的疗效,急性白血病最长活存已五年半,恶淋病人最长也五年多,缓解了晚期肿瘤病人疼痛。在轻、中度骨髓型急性放射病人还验证了抗辐射药物效价,较以往分次照射肿癌病人模式易于评价。还带动了我院HLA专业实验室的发展。     

外照射慢性放射病人的剂量估算

本文报道了外照射慢性放射病人(简称慢放病人)的剂量估算。根据射线工作量、X线机型号和容量、防护条件, 采用全国对x射线工作人员的剂量调查资料或对慢放病人的实际监测数据, 对从事x射线诊断的慢放病人进行了剂量估算。根据镭源活度、操作时间、离源距离, 及其镭疗的病人次数, 对早期从事谲疗工作的巨放病人进行了剂量估算。给出了29例慢放病人剂量的估算结果。其照射量(无受体)、红骨髓剂量、躯干平均剂量和有效剂量当量的平均值分别为7.5×10^-2C·kg^-11.3Gy、1.2Gy和1.6Sv。     

同种异基因胎肝移植治疗急性放射病的临床研究

本文报道4例眙肝细胞移植治疗事故性(例1)或医疗性(例2～4)重度骨髓型急性放射病的临床研究,全身照射剂量:倒l为5.2Gy;浏2～4分别为5.5,5.0和5.0Gy.后3例并用大剂量化疗:环磷醚胺80mg/kg,输入胎肝细胞数2.26～4.1×10³/kg体重(胎肝数l～13个).除1例有局限于皮肤的I级轻篓抗宿主病外,其余无不良反应。提出胎肝细胞移植或输注在事故性照射引起中度以上骨髓型急性放射病,又缺乏HLA相合供者钓情况下不失为一有用的治疗措施。对3例急性白血病也是一个治疗措施,1例已生存近5年,另一例也已3年多。     

部分照射离体血对淋巴细胞染色体畸变形成的影响

目的 分析⁶⁰Coγ射线部分照射离体血对人外周血淋巴细胞染色体畸变形成的影响。方法 用2Gy⁶⁰Coγ射线37℃照射人外周血后以不同比例混合后进行培养、制片和分析染色体畸变。结果 染色体畸变随照射血比例的增加而增加,与单纯照射组相比,混合照射血的染色体畸变率高。1:1比例混合估算出的剂量为1.27Gy,大于1Gy;0.5:1比例混合估算出的剂量为0.93Gy,大于0.5Gy;而在1:0组,照射剂量与估算剂量基本一致。结论 染色体畸变可以作为估算非均匀照射的生物学指标之一。     

两例急性放射病患者血液学改变的特点

本文对两例急性放射病患者的血液学变化进行了观察。两例受照剂量“亮”为3.5 Gy,“燕”为2.6Gy。根据WBC总数的变化,参考血小板计数及早期淋巴细胞绝对值,并与其它放射性事故比较,认为“亮”属中度或中度偏重骨髓型急性放射病;“燕”届中度或中度偏轻骨髓型急性放射病,与临床经过及物理剂量相符。两例均在骨髓涂片的巨核细胞内见到其它血细胞,对这种现象作了初步讨论,对其临床意义尚需进一步观察阐明。     

南京“5.7” 192Ir源放射事故患者的生物剂量估算

目的 用3种方法估算南京"5.7" ¹⁹²Ir源放射事故患者的生物剂量,为核与辐射事故受照者的临床救治提供剂量资料。方法 受照后第5天采集患者外周血,分别进行外周血淋巴细胞染色体"双着丝粒+环"("dic+r")畸变分析、胞质分裂阻滞微核(CBMN)分析、核质桥(NPB +FHC)分析,并估算生物剂量。用双着丝粒畸变在细胞间的泊松分布情况检验照射的均匀性。结果3种方法估算的该患者受到的一次全身等效剂量分别为"dic+r"畸变分析1.51 Gy (95% CI 1.40~1.61),CBMN 分析1.47 Gy (95% CI 1.36~1.60),NPB+FHC分析1.30 Gy(95% CI 1.00~1.60)。泊松分布检验结果显示,该患者"dic+r"畸变偏离泊松分布,受到了不均匀照射。结论 外周血淋巴细胞染色体"dic+r"畸变分析、CBMN分析、NPB+FHC分析均是有效的生物剂量估算手段,对本例急性局部不均匀照射患者估算的一次全身等效剂量与临床诊断结果相符。     

放疗患者全身血液平均受照剂量的估算

本文用检查外周血染色体畸变的方法,对下半身(HBI)和全淋巴区照射(TLI)患者的全身血液平均受照剂量,进行了实验研究.本研究共观察了19名接受⁶⁰Co γ线治疗的患者,萁中HBI10名,TLI 9名,病人的受照剂量均为8 Gy.放疗前采每位患者的静脉血样,将染色体畸变检查结果作为对照值.放疗后24小时再做一次检查,计算照射诱发的双着丝粒(dic)产额,代入经过剂量率影响校正的回归方程,反堆出HBI和TLI患者的全身血液平均受照剂量,分别为155cGy和40cGy.本研究推算出的剂量与患者照射后的临床表现是符合的.     

497例眼晶状体调查

本文用检查外周血染色体畸变的方法,对下半身(HBI)和全淋巴区照射(TLI)患者的全身血液平均受照剂量,进行了实验研究.本研究共观察了19名接受⁶⁰Co γ线治疗的患者,萁中HBI10名,TLI 9名,病人的受照剂量均为8 Gy.放疗前采每位患者的静脉血样,将染色体畸变检查结果作为对照值.放疗后24小时再做一次检查,计算照射诱发的双着丝粒(dic)产额,代入经过剂量率影响校正的回归方程,反堆出HBI和TLI患者的全身血液平均受照剂量,分别为155cGy和40cGy.本研究推算出的剂量与患者照射后的临床表现是符合的.     

南宁地区住民X线诊断检查频率

本文用检查外周血染色体畸变的方法,对下半身(HBI)和全淋巴区照射(TLI)患者的全身血液平均受照剂量,进行了实验研究.本研究共观察了19名接受⁶⁰Co γ线治疗的患者,萁中HBI10名,TLI 9名,病人的受照剂量均为8 Gy.放疗前采每位患者的静脉血样,将染色体畸变检查结果作为对照值.放疗后24小时再做一次检查,计算照射诱发的双着丝粒(dic)产额,代入经过剂量率影响校正的回归方程,反堆出HBI和TLI患者的全身血液平均受照剂量,分别为155cGy和40cGy.本研究推算出的剂量与患者照射后的临床表现是符合的.     

两例钴源事故受照者和体外照射正常人外周血的红细胞GPA变异频率分析

目的 :检测上海“6 .2 5”事故两例中度骨髓放射病病人 8年后血型糖蛋白A(GPA)变异频率和估算物理剂量的相关性 ;同时测定正常人外周血在体外用γ线照射后红细胞GPA的变化。方法 :取正常人和事故患者外周血 ,分离红细胞并固定 ,在和荧光素标记的单抗结合后用流式细胞仪进行GPA分析 ,计算GPA变异频率 ;以两组正常人血样分批体外照射 1,2 ,5,10Gy ,在照射后放置 1,4 ,6d后进行检测。结果 :与正常人相比 ,两事故病例的GPA变异频率较高 ,其中变异频率较高者其估算受照剂量较高 ;体外照射外周血红细胞达 10Gy也未见GPA变化。 结论 :放射病病例变异红细胞频率与估算剂量间成正相关 ;外周血直接受照中度剂量不能导致GPA变化 ,提示GPA突变反映造血干细胞损伤 ,GPA分析法适合放射病远后效应跟踪研究     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.